NPIMap

Individual provider Active NPI

Jake Duggan, MD

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1699268870
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD478587 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3326
NPI assigned
Jun 12, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MT215705 PA
Anesthesiology Physician 207L00000X MD478587 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3500 N Broad Street
001A
Philadelphia, PA 19140-5103
Phone (215) 707-3411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220830000689 PA Practitioner - Anesthesiology 9638425002 Reassigns benefits to 1 organization
I20230605003374 MA Practitioner - Anesthesiology 9638425002 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD478587PAMDAnesthesiology Physician
MT215705PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Anesthesiology Associates, Inc Anesthesiology CurrentSince Nov 1, 2023 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Aug 1, 2022 Accepting new patients
Temple Faculty Practice Plan Inc Anesthesiology Current Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Anesthesiology CurrentSince May 1, 2023 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Aug 1, 2022 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince May 1, 2023 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

25 Highland Ave
Newburyport, MA 01950
Phone (978) 258-4734

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

3401 N Broad St
Ste 810
Philadelphia, PA 19140
Phone (215) 707-2772

3500 N Broad St
#1A
Philadelphia, PA 19140

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1699268870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD STREET",
            "address_2": "001A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGGAN",
        "first_name": "JAKE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-12",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MT215705",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD478587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.